Organization
NDS RADIOLOGY PLLC
Active
Organization
NDS RADIOLOGY PLLC
Active
Other names
National Diagnostic Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KETSLAKH (CEO)
(248) 476-6980
Entity
Organization
Contact information
Practice address
28700 CABOT DR STE 500, NOVI, MI 48377-2949
(248) 476-6980
(248) 476-7462
Mailing address
28700 CABOT DR STE 500, NOVI, MI 48377-2949
(248) 476-6980
(248) 476-7462
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
195714
CIGNA
—
01
—
700F322820
BCBS/BCN
MI
01
—
7135655
AETNA
MI
Enumeration date
10/18/2005
Last updated
02/11/2025
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